Observatorium als alternatief voor opname op afdeling na trauma

Madsen TE, Bledsoe JR, Bossart PJ. Observation unit admission as an alternative to inpatient admission for trauma activation patients. Emerg Med J 2009 Jun;26(6):421-3

At this 35 000 visits/year emergency department (ED) at a level one trauma centre, a trauma protocol was implemented for the ED observation unit. Data on all trauma observation unit admissions were then collected to evaluate for safety, efficiency and admission rates.

METHODS: A retrospective chart review was performed of all trauma patients in the observation unit during a 14-month period. Exclusion criteria for observation unit admission included: abnormal vital signs, positive focussed abdominal sonography for trauma examination, abnormal ECG, abnormal chest radiograph, abnormal head computed tomography, Glasgow coma score less than 14, or multisystem trauma. RESULTS: 364 trauma patients were admitted to the observation unit. 84.6% were trauma II activations and 3.8% were trauma I activations. There were no deaths, intubations, loss of vital signs or other adverse events. The average length of stay was 12 h 46 minutes and 11.5% of patients were admitted to an inpatient unit. At 30-day follow-up, there were no significant missed injuries. CONCLUSION: The observation unit is a safe alternative to inpatient admission for the evaluation of the minimally injured trauma activation patient

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